World Journal of Dentistry

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2019 | September-October | Volume 10 | Issue 5

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Sneha Patil, Amol R Gadbail, Shailesh Gondivkar

A Perspective on Bibliometric Analysis Papers in the Field of Dentistry

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:2] [Pages No:325 - 326]

   DOI: 10.5005/jp-journals-10015-1674  |  Open Access |  How to cite  | 



Valë H Hoxha, Agim Begzati, Vlorë H Cakolli

Determination of Microbiological Salivary Status in Children with Upper Respiratory Tract Disorders

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:8] [Pages No:327 - 334]

Keywords: Enlarged tonsils, Lactobacilli, Middle ear infection, Mutans streptococci, Oral health

   DOI: 10.5005/jp-journals-10015-1664  |  Open Access |  How to cite  | 


Aim: The purpose of this paper is to investigate the prevalence of dental caries and the types of streptococci mutant and Lactobacillus in the saliva of children with middle ear infection (MEI), enlarged tonsils (ET), and healthy children. Materials and methods: A sample of 93 subjects (57 males and 36 females; mean age: 8.1 ± 1 years, aged between 5 years and 15 years old) were assessed: 35 patients, with MEI, and 26 with ET, formed the study group, while 32 healthy subjects formed the control group. The participants were interviewed regarding demographic data, dietary, and oral hygiene habits. Their dental caries and oral hygiene status were clinically determined, assessing diagnostic criteria for decayed, missing, and filled teeth for primary (dmft) and permanent (DMFT) dentition, oral hygiene index according to Greene–Vermillion, and the gingival index (GI) according to Silness–Löe. Stimulated salivary flow rate, and salivary mutans streptococci (MS) and lactobacilli (LB) were also determined. Results: The groups were similar with respect to gender, using fluoride paste, visits to dentist, family income (p > 0.05), whereas there was a difference in age, educational level, method of feeding, use of pacifier, sweet eating habits, toothbrushing, saliva secretion, and rate of oral breathing (p < 0.001) between intervention and healthy group. However, higher salivary MS and LB levels were observed in MEI, and ET patients compared to controls (p < 0.05). Conclusion: Our results demonstrated that patients with ET and MEI had more initial caries, gingival inflammation, dental plaque, a lower stimulated salivary secretion rate, and an increase in the level of salivary MS and LB than healthy individuals. Clinical significance: Results from our study will help not only the pediatric dentistry specialists but also the other medical professionals like pediatricians, ENT specialists, and nurses to increase their awareness regarding the importance of the overall dental health in children with an ear infection or tonsillitis.



Effect of Resilient Liner on Peri-implant Structures in Early Loading Ball and Socket Implant Supported Overdentures

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:335 - 339]

Keywords: Implant-supported, Liners, Overdentures, Reinforced acrylic resin

   DOI: 10.5005/jp-journals-10015-1670  |  Open Access |  How to cite  | 


Background: The effects of fiber-reinforced acrylic base liner on peri-implant structures in early loading implant-supported overdenture are not thoroughly investigated. Hence, the aim to this study was to evaluate the effect of fiber-reinforced acrylic denture base resin liner on clinical and radiographic parameters in early loading implant supported overdentures. Materials and methods: Fifteen edentulous male patients, aged 50–60 years were randomly (lottery method) classified into two groups: group I (controls, n = 5) having 4 ball and socket implants without resilient liner, group II (study group, n = 10) having ball and socket attachments with resilient liner. Group II was further divided into two subgroups: subgroup A (n = 5) having 2 ball and socket implants with resilient liner and subgroup B (n = 5) having 3 ball and socket implants with resilient liner. Implant mobility, implant survival, sulcular depth around the implant and bone height were evaluated every 3 months for 1 year. General linear models were used to test the difference in the mean crevicular depth and mean bone height (ratio) around implants in both groups during the follow-up periods. Statistical significance was determined at α = 0.05. Results: No mobility was reported and the implant survival was 100%. There was an increase in the mean crevicular depth around implants in both groups at different time intervals. The increase was higher in group II (p < 0.05). There was a decrease in the mean bone height around the implants in both groups at different time intervals; however, this difference was not statistically significant (p > 0.05). Conclusion: Furthermore, the number of implants had no significant role in the success or failure of the implant-supported overdentures.



Shilpa C Natesan, Rekha Krishnapillai

Immunohistochemical Expression of Fascin in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:6] [Pages No:340 - 345]

Keywords: Fascin, Head and neck cancer, Immunohistochemistry, Oral cancer, Oral epithelial dysplasia, Oral leukoplakia, Oral squamous cell carcinoma

   DOI: 10.5005/jp-journals-10015-1658  |  Open Access |  How to cite  | 


Aims: The present study aimed to evaluate and compare the expression of fascin in normal oral mucosa (NOM) and oral epithelial dysplasia (OED) and to estimate the expression in different grades of oral squamous cell carcinoma (OSCC). Materials and methods: The study involves a total of 55 cases including 30 cases of OSCC, 15 cases of OED, and 10 NOM tissues. All the sections were subjected to fascin immunostaining. Epithelial dysplasia were scored by layer-wise immunohistochemical staining, while for carcinoma staining intensity and number of cells stained were assessed. The scores were analyzed using one-way ANOVA test and Tukey's post hoc test. Results: Our results showed that fascin expression in NOM was very low or restricted to the basal layers of the epithelium. In case of OED and OSCC, fascin immunostaining was highly elevated. Also, it was seen increasing with increasing grades of dysplasia (p = 0.002) and decrease in differentiation of OSCC. Conclusion: A steady up-regulation of fascin expression is noted in OED and squamous cell carcinoma. These findings suggest that fascin plays an important role from early stages of carcinogenesis to invasive carcinoma. Clinical significance: Fascin can be used as a reliable biomarker for diagnostic and prognostic implications of OED and OSCC, respectively.



Fatima M Jadu, Ahmed M Jan

A Comparative Study of Periapical Radiographs and Cone-beam Computed Tomography to Detect the Effects of Periapical Lesions

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:4] [Pages No:346 - 349]

Keywords: Cone-beam computed tomography, Diagnostic accuracy, Periapical lesion, Periapical radiographs, Root resorption

   DOI: 10.5005/jp-journals-10015-1667  |  Open Access |  How to cite  | 


Aim: To compare the diagnostic performance of cone-beam computed tomography (CBCT) relative to periapical radiographs (PAs) for detecting the effects of periapical lesions (PLs) on the roots and surrounding structures. Materials and methods: This prospective study considered teeth with PLs referred for extraction. To be included, the teeth must also have a recent diagnostic quality PA and a recent CBCT examination with the tooth in question imaged clearly. The images were anonymized, scrambled, and reviewed by two calibrated observers. The extracted teeth were sent along with their periapical tissues for histopathologic examination. Data collected included patient age and gender, the tooth in question, and the histopathologic diagnosis of the apical tissues. The observers were required to record the presence or absence of root resorption, encroachment on the maxillary sinus, and compression of the mental foramen and/or mandibular canal. Results: Cone-beam computed tomography performed superior to PA, detecting more effects on the surrounding structures, but this was only statistically significant for the effect of external root resorption (ERR) (p < 0.001). This was true irrespective of the histopathologic diagnosis of PL. Conclusion: The diagnostic performance of CBCT was significantly superior to that of PA for detecting ERR on teeth with PL. Clinical significance: The diagnostic accuracy of CBCT exceeds that of PA for detecting the effects of PL. However, the diagnostic accuracy is one of many factors to consider when choosing a diagnostic imaging modality for a specific task. Overall, CBCT examinations should be reserved for challenging cases after PAs have failed to provide all the required diagnostic information.



Shankaran V Sreelatha, Sukanya Shetty, Vimal K Karnaker, Chitta R Chowdhury

Patterns of Tobacco Consumption among Oral Squamous Cell Carcinoma Cases Attending a Tertiary Care Dental Hospital in Coastal Karnataka of India

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:4] [Pages No:350 - 353]

Keywords: Carcinoma, Habits, Smoke, Squamous cell, Tobacco

   DOI: 10.5005/jp-journals-10015-1663  |  Open Access |  How to cite  | 


Aim: Oral squamous cell carcinoma (OSCC) contributes to 30% of the cancers in India. Harmful use of tobacco and alcohol is implicated in the pathogenesis of oral cancer. This study aimed at describing the tobacco consumption patterns in patients of OSCC visited in a tertiary care dental hospital in coastal Karnataka, India. Materials and methods: A cross-sectional study of 108 cases of OSCC from 2015 to 2018 was carried out in a tertiary care dental hospital. Demographic details of the patients’ sex, age, tobacco habit, and site of cancer were entered into MS Excel. Data were analyzed using SPSS version 20. The tobacco consumption pattern was expressed in percentages and proportions, and the association between the variables was determined by Chi-square (χ2) test and the Mann–Whitney U test. Results: Of the 108 cases of OSCC, 84 (77.8%) were males. The most common site of the OSCC was the buccal mucosa along the gingivobuccal sulcus, which was seen in 65 (60.20%) cases. In males, the most common type of tobacco consumed was in the smoked form, which was observed in 39 (46.4%) cases, and among females the smokeless tobacco (ST) consumption was found in 15 (62.5%) cases. Conclusion: The most common site for OSCC was the buccal mucosa along with the gingivobuccal sulcus. The most common types of tobacco consumed in patients with OSCC were smoked form in males and ST in females. Clinical significance: There is a need to work toward public awareness about the detrimental effects of tobacco practice and oral cancer screening programs, which might prevent the morbidity and mortality of OSCC in this region due to early diagnosis that is achievable.



Sai Darshana Nair, Alluri Siddhartha Varma, Girish Suragimath, Sameer A Zope, Apurva Pisal, Rashmi Gangavati

A Clinical and Radiographical Study to Assess and Correlate Chronic Obstructive Pulmonary Disease and Periodontitis

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:354 - 358]

Keywords: Bone loss, Chronic obstructive pulmonary disease, Periodontitis

   DOI: 10.5005/jp-journals-10015-1665  |  Open Access |  How to cite  | 


Aim: In the past few years, there has been accumulating evidence that suggests an exquisite association between oral infections and systemic diseases. Both chronic periodontitis and chronic obstructive pulmonary disease (COPD) are inflammatory conditions characterized by the loss of local connective tissue. The current study was conducted to find the association between COPD and periodontitis. Materials and methods: The present cross-sectional study comprised of 60 individuals after obtaining their due consent. All the subjects enrolled were subjected to a spirometric test, from which COPD patients were graded into four categories A, B, C, and D according to their COPD status. A detailed periodontal examination was performed using parameters like probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI). Orthopantomogram (OPG) of each individual was taken to assess the mean alveolar bone loss (MABL). Results: The results showed that with the worsening of spirometric values (i.e., from A to D), there was a significant deterioration in the periodontal health in terms mean PPD, CAL, PI, GI, and MABL with a p value < 0.05. Conclusion: The present study showed a positive association between COPD and periodontal health status. Periodontal health variables were considerably associated with the severity of COPD. Clinical significance: It is essential to attach significance to the COPD patient's periodontal health. Active management of the periodontal disease may have more favorable effects on the COPD patients. Furthermore, exploring the effect and mechanism of the treatment of periodontal disease on the COPD is worthy of efforts.



Pooja Keshrani, Nimisha Shah, Nishtha Patel, Kamal Bagda, Payal Patel

Sealing Ability of Two Different Furcal Perforation Repair Materials with and without Internal Matrix: An In Vitro Study

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:359 - 363]

Keywords: Furcation perforation, ProGide, ProRoot MTA

   DOI: 10.5005/jp-journals-10015-1657  |  Open Access |  How to cite  | 


Aim: To evaluate the sealing ability of mineral trioxide aggregate (MTA) and resin-modified glass ionomer cement (RMGIC) to seal the furcal perforation with and without internal matrix. Materials and methods: Sixty freshly extracted intact human permanent mandibular molars were selected. After creating furcal perforation, the teeth were randomly divided into four experimental groups containing 15 teeth each according to the furcal perforation repair materials used. Group I—RMGIC without internal matrix. Group II—RMGIC with internal matrix. Group III—MTA without internal matrix. Group IV—MTA with internal matrix. To evaluate the sealing ability of furcal perforation, dye extraction method was performed using 2% methylene blue dye and 65% concentrated nitric acid. Spectrophotometer was used for measuring dye absorbance at 550 nm. Results: Group I (RMGIC without internal matrix) showed highest microleakage followed by group II (RMGIC with internal matrix), group III (MTA without internal matrix), and group IV (MTA with internal matrix). There was a significant difference found between group I and group II, but there was no significant difference seen between group III and group IV. Conclusion: Mineral trioxide aggregate has excellent sealing ability and can be used with and without internal matrix in repair of furcation perforation. Resin-modified glass ionomer cement should be used with internal matrix to repair furcation perforations. Clinical significance: Mineral trioxide aggregate with and without internal matrix whereas RMGIC with internal matrix have been successfully used in repair of furcation perforation.



Fatima AlOtaibi, Maha Altamami, Noura Alsuwailem, Latifah M Almasaud, Refah A AlSubaie, Rayada A Alhabeb

Laypeople's Perspective of Esthetically Pleasing Smile in Kingdom of Saudi Arabia: A Cross-sectional Survey

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:10] [Pages No:364 - 373]

Keywords: Diastema, Esthetic, Gummy smile, Laypeople, Smile, Treatment

   DOI: 10.5005/jp-journals-10015-1662  |  Open Access |  How to cite  | 


Aims: This study aimed to identify the self-perceived acceptable and pleasant smile characteristics and preferred dental esthetic treatments among laypersons from Kingdom of Saudi Arabia. Materials and methods: This was a cross-sectional survey conducted among laypeople in Riyadh city. A structured, close-ended, and self-administered questionnaire was distributed through social media to assess the participant's satisfaction with their smiles and desire to improve their smiles through various esthetic treatment modalities. Results: Majority of the participants were female (87%, n = 783) compared to the male (13%, n = 117). A total of 355 (39.4%) subjects were dissatisfied with the color of their teeth and the level of dissatisfaction was higher among female, 317 (89.3%) compared to the male, 38 (10.7%). Moreover, younger participants showed significantly higher dissatisfaction with color of their teeth compared to the other age groups (p = 0.002). Gender (p = 0.001) and age (p = 0.000) of the study subjects were found to be significantly associated with different whitening procedures. Similarly, education of the study participant is significantly associated with satisfaction with the appearance of teeth during smiling (p = 0.028). Pointed canines (75.7%), gummy smile (88.6%), wide smile (95.7%), and gap between the teeth (99.4%) were found to be significantly less attractive among study participants. Conclusion: The findings of this study revealed that perception of color and dental appearance of the teeth varies among different subjects. Hence, understanding the layperson's opinion about the color of the teeth and appearance is important parameters in designing esthetically attractive smile for the patients. Clinical significance: Laypeople's perception of esthetically pleasing smile is influenced by age, gender, and education of the individuals. Hence, while designing esthetically pleasing smile, these factors should be considered to get best clinical outcomes.



Khaled M Mohamed, Fatima M Jadu, Hala M Abdelalim, Amr M Bayoumi, Ahmed M Jan

Impact of Methods for Teaching Inferior Alveolar Nerve Block Anesthesia on Dental Students’ Efficiency

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:374 - 378]

Keywords: Anesthesia, Dental, Oral surgery

   DOI: 10.5005/jp-journals-10015-1668  |  Open Access |  How to cite  | 


Aim: Several methods are available for teaching local anesthesia (LA) administration to dental students. The aim of this study was to examine the effect of two teaching methods [student-to-student learning and peer-assisted learning (PAL)] on third-year dental students’ efficiency in administering inferior alveolar nerve blocks (IANBs). Materials and methods: After ethical approval, the study was conducted over three academic years (2016–2018). During the first year, the third-year dental students (control group) were taught IANB administration techniques using the student-to-student method. During the second year, a new group of third-year dental students (study group) were taught the IANB administration technique using two methods (student-to-student and PAL). All the students were assessed the following academic year (when the students became fourth-year students) by oral and maxillofacial surgery (OMFS) faculty using six evaluation items. Results: According to the six evaluation criteria, the study group that was taught IANB using the student-to-student and PAL teaching techniques performed superior to their peers in the control group. Three of the six evaluation criteria were statistically significantly different between the two groups of students: recording the dental and medical history (p = 0.018), recognizing the anatomy and the injection procedure (p = 0.004), and assessing the success of the anesthesia (p = 0.026). Conclusion: Combining the student-to-student and PAL teaching techniques for IANB administration resulted in better student efficiency than using only the student-to-student technique. Clinical significance: Peer-assisted learning is an effective teaching method that can be used to enhance the learning experience of dental students who are attempting to master IANB techniques.



Mohamed T Hamed

A Clinical Study Assessing the Surrounding Bone Levels and Bone Density of Implant-borne and Implant-tooth-fixed Partial Dentures

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:379 - 383]

Keywords: Alveolar bone height, Bone density, Tooth-implant-supported fixed partial denture

   DOI: 10.5005/jp-journals-10015-1669  |  Open Access |  How to cite  | 


Background: Advanced developments in the field of dentistry have observed the utilization of implants as a manageable treatment approach for edentulous patients. In addition, the rapid emergence of cone-beam computed tomography (CBCT) is aforethought significant, particularly for optimum implant installation. The objective of this investigation is to radiographically evaluate the bone density and alveolar bone height in the vicinity of implants and premolars in tooth-implant sustained fixed partial dentures (FPDs) with rigid connector vs implant–implant supported FPDs with rigid connector using CBCT. Materials and methods: The height and width of the implant were taken into consideration. A sample of eight patients was used having both males and females, aged between 30 years and 45 years with good oral hygiene and divided into two groups. Patients within group I were given a tooth-implant-supported FPD associated to the dental implant at the site of mandibular second molar. On the contrary, patients of group II were given an implant–implant FPD associated to a distal implant at the site of second molar. For evaluating the bone quality of each patient, preoperative panoramic radiographs using the orthopantomograph OT 100 and CBCT images using Scanora 3D were constructed. Results: The findings of the current study indicated that there was no statistically substantial discrepancy among values of bone density in groups. Conclusion: It is concluded that progressive loading tends to increase the bone density by time.



Karthik R Mohan, Mohan Narayanan, Pethagounder Thangavel Ravikumar, Saramma M Fenn, Sabitha Gokulraj, Amirthaleka

Evaluation of NSAIDs in Acute Odontogenic Pain: A Quadriblind Study

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:6] [Pages No:384 - 389]

Keywords: Analgesics, Irreversible pulpitis, Odontogenic pain

   DOI: 10.5005/jp-journals-10015-1649  |  Open Access |  How to cite  | 


Odontogenic pain refers to pain arising from the teeth or their supporting structures, the oral mucous membrane, the maxilla or mandible, or periodontal ligament membrane. Management of odontogenic pain becomes challenging in the modern era to the clinician due to its diversified etiologies. Aim: The primary aim is to evaluate the efficacy of NSAIDs in treating acute odontogenic pain due to acute pulpitis, acute periapical abscess, and acute pain after root canal therapy. Materials and methods: Patients visiting the outpatient department, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation, with odontogenic pain due to acute pulpitis and acute periapical abscess were randomly selected. A total of 80 patients were considered and divided into 4 groups (n = 20 were prescribed paracetamol, n = 20 were prescribed ibuprofen, n = 20 were prescribed aceclofenac, n = 20 were prescribed ketorolac). The patients in each group were not aware of the analgesic drug prescribed. (quadriblind drug trial). Pain was analyzed by the visual analog score (VAS) graded from 0 to 10, and the VAS scores were recorded at initial, 30-minutes, 1-hour, and 2-hours intervals. Result: Ketorolac is better in relieving the odontogenic pain when compared to paracetamol, ibuprofen, and aceclofenac. Conclusion: Ketorolac is an effective NSAID in relieving the odontogenic pain. Clinical significance: This study helps to evaluate the effectiveness of nonsteroidal anti-inflammatory drugs for odontogenic pain and helps in identifying the more potent NSAID for odontogenic pain without the use of inferior alveolar nerve block.



Fatima M Jadu

Number and Nature of Incidental Findings in Cone-beam Computed Tomography Made for Oral Surgery Purposes

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:3] [Pages No:390 - 392]

Keywords: Cone-beam computed tomography, Incidental findings, OMFR, Oral and maxillofacial surgeon

   DOI: 10.5005/jp-journals-10015-1659  |  Open Access |  How to cite  | 


Aim: Oral and maxillofacial surgeons (OMFSs) request cone-beam computed tomography (CBCT) examinations more than any other dental specialty. The aim of the current study was to determine the frequency and type of incidental findings (IFs) from CBCT examinations specifically requested by OMFSs. Materials and methods: The database of a university-based CBCT service was reviewed for examinations requested by an OMFS over a 1-year period. The indications for the CBCT request ranged from implant and impaction to trauma-related causes. A board-certified oral and maxillofacial radiologist (OMFR) reviewed the CBCT images and the collected data were analyzed for descriptive results. Results: The frequency of IFs was 78%. The greatest number of IFs was found in the paranasal region followed by the cervical vertebrae and the nasopharyngeal area. Most IFs were insignificant but nearly half the cases (48%) required a follow-up or referral appointment. Conclusion: IFs from CBCT examinations requested by OMFSs are common and a substantial number required follow-up or referral. Clinical significance: The results of the current study highlight the importance of examining the entire volume of CBCT examinations and reporting any and all IFs. This, in turn, requires adequate knowledge and training in CBCT image interpretation or, alternatively, effective collaboration with oral and maxillofacial radiologists.



Kurnool Balaji, T Sai Pravallika

A Comparative Evaluation of the Accuracy of Two Electronic Apex Locators and Radiovisiography to Determine the Working Length

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:3] [Pages No:393 - 395]

Keywords: Apex locator, Radiovisiography, Working length

   DOI: 10.5005/jp-journals-10015-1671  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to compare the working length in primary teeth using intraoral digital radiovisiography and two apex locators for accuracy. Materials and methods: This is an in vivo study done in 30 primary teeth which are indicated for pulpectomy in children aged 5–9 years. All the teeth selected for the study had adequate remaining tooth structure for rubber dam isolation and radiographically visible canals. During the pulpectomy procedure, the working length was determined by digital radiovisiography and apex locator. The teeth were divided into three groups: group I—radiovisiography, group II—apex locator-I (Root ZX mini), and group III—apex locator-II (i-ROOT). The measurements were then compared for accuracy. Results: There is no significant difference in the mean root length measurements from the three techniques. Conclusion: The study concludes that electronic method for determining the working length of root canal was found to be more accurate than the radiographic method. Clinical significance: The clinical correlation can be interpreted from the fact that the more the machine can work in extreme environments the more accurate it is, and the better it is for the dental professionals.



Pooja R Disale, Sameer Zope, Girish Suragimath, Alluri Siddhartha Varma, Apurva Pisal

Toll-like Receptors: Molecular Microbe Sensors in Periodontium

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:6] [Pages No:396 - 401]

Keywords: Cytokines, Inflammatory response, Innate immunity, Pattern-recognition receptors

   DOI: 10.5005/jp-journals-10015-1666  |  Open Access |  How to cite  | 


Aim: This review aims to highlight the emerging role of toll-like receptors (TLRs) in pathogenesis of periodontitis and negative regulation of TLR signaling. Background: Periodontal disease is the common chronic bacterial infection of the supporting structures of the teeth characterized by the tissue destruction. Bacterial plaque stimulates the host inflammatory response. It is now known that the immune response utilizes a family of pattern-recognition receptors (PRRs) called TLR as a tool to trigger an inflammatory response to microbial invasion. The TLRs expressed by epithelial cells of gingiva are constantly stimulated which release cytokines and defensins required for maintenance of oral health. The chronic stimulation of TLRs may leas to the disruption of epithelial barrier and allows microorganisms to enter the underlying connective tissue. This further activates TLRs present on additional cells of the periodontium, i.e., resident and non-resident cells. These TLRs activation may cause host tissue destruction due to an overproduction of proinflammatory cytokines as well other biological mediators. Review results: The electronic databases PubMed, MEDLINE, Cochrane, Scopus and Google Scholar were searched for available data in the present review. A database search yielded a total of 94 articles out of 56 included based on the core data. The results and subsequent conclusions were extracted and reviewed. Conclusion: It may be concluded that TLR signaling is crucial for maintenance of periodontal health as well as initiation and progression of periodontal disease. In spite of this, there are still lacks of information regarding the functional polymorphisms of genes that are involved in the stimulation and regulation of lipopolysaccharide mediated inflammatory processes. Clinical significance: Overactive TLRs might pivot into chronic inflammation, and so targeting TLRs might therefore lead to remission from this chronic inflammation. Therefore, further investigations are necessary to expand our knowledge to understand and develop therapies for major pathologic conditions.



Chaya Chhabra, Kumar G Chhabra, Akanksha Goyal, Gururaghavendran Rajesh, Almas Binnal

Pharmacovigilance: The Least Understood and Least Practiced Science in Dentistry

[Year:2019] [Month:September-October] [Volume:10] [Number:5] [Pages:5] [Pages No:402 - 406]

Keywords: Dental professionals, Indian scenario, Pharmacovigilance

   DOI: 10.5005/jp-journals-10015-1661  |  Open Access |  How to cite  | 


Aim: The purpose of this review was to explore the overall scenario of pharmacovigilance, its aims, challenges, and recommendations pertaining to dentistry for further improvements. Materials and methods: Literature search was done with the help of the Endnote software, followed by vigilantly arranging the material in a coordinated way. Results: Adverse drug reactions (ADRs) are among the top 10 leading causes of all-cause mortality. In order to reduce the harm to the patients and serve the public health mission, there is a definite need for developing mechanisms for evaluating and monitoring the safety of medicines in India. Therefore, the requirement for developing a well-organized pharmacovigilance system is imperative. Different countries have developed their own reporting guidelines for pharmacovigilance. The reporting guidelines are conceived to adapt to the specific requirements of any country and the prime focus of these adverse event reporting systems is improving the patient's health and safety. The Central Drugs Standard Control Organization (CDSCO) has initiated a nation-wide pharmacovigilance program in India. It aims to protect the health of the patients by assuring drug safety under the aegis of Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. In dentistry, the science of pharmacovigilance is rarely applied and its practice among dental health professionals, including reporting of ADRs, is minimal. However, studies have shown that the dental professionals comprehend the importance of pharmacovigilance and its application in dentistry. Conclusion: It is essential to foster a sense of trust among patients regarding the medicines they use, to ensure that risks in drug use are anticipated and managed. This will eventually enhance the confidence of patients on the healthcare delivery system in general. Clinical significance: The practice of dentistry involves prescribing various medications for patient use. It is therefore the duty of the dentist to comprehend and identify the adverse effects of the drugs. Dentists should also know about the right channel for reporting any instances of ADRs. They should also strive toward increasing the awareness among patients regarding possible side effects so that any untoward consequences can be avoided. This will be an invaluable aid in furthering the public health mission of improving the health of the populations.


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